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Immune gene expression analysis for oral leukplakia samples

ABSTRACT: Oral leukoplakia is common and may in some cases progress to carcinoma. Proliferative leukoplakia (PL) is a progressive, often multifocal subtype with a high rate of malignant transformation (MT) compared to the more common localized leukoplakia (LL). We hypothesized that the immune microenvironment and gene expression patterns would be distinct for PL compared to LL. We summarize key clinicopathologic features among PL and LL and compare cancer-free survival (CFS) between subgroups. We analyze immunologic gene expression profiling (GEP) in PL and LL tissue samples (NanoString PanCancer Immune Oncology Profiling). We integrate immune cell activation and spatial distribution patterns in tissue samples using multiplexed immunofluorescence and digital image capture to further define PL and LL. Among N=58 patients (PL: 29, LL: 29), only the clinical diagnosis of PL was associated with significantly decreased CFS (HR 11.25, p<0.01); 5-year CFS 46.8% and 83.6% among PL and LL patients, respectively. CD8+ T cells and Tregs were more abundant among PL samples (p<0.01) regardless of degree of epithelial dysplasia, and often colocalized to the dysplasia-stromal interface. Gene set analysis identified granzyme-M (GZMM) as the most differentially expressed gene favoring the PL subgroup (log2 fold change 1.93, adjusted p<0.001). PD-L1 was comparatively over-expressed among PL samples, with higher (>5) PD-L1 scores predicting worse CFS (p<0.01). PL predicts a high rate of MT within 5-years of diagnosis. Robust CD8+ T cell and Treg signature along with relative PD-L1 over-expression compared with LL provides strong rationale for PD-1/L1 axis blockade using preventative immunotherapy.

ORGANISM(S): Homo sapiens

PROVIDER: GSE184944 | GEO | 2021/10/15

REPOSITORIES: GEO

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